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This is VAERS ID 26626

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 26626 (history)  
Form: Version .0  
Age: 1.4  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-11-07
Onset:1990-11-07
   Days after vaccination:0
Submitted: 1990-11-08
   Days after onset:1
Entered: 1990-11-14
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 259959 / 2 LL / IM
HIBV: PROHIBIT / CONNAUGHT LABS 0A21133 / 0 RL / -
MMR: MMR II / MSD 1703S / 0 RA / -
OPV: ORIMUNE / LEDERLE 0618A / 2 - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: FEBRILE SEIZURE, OTITIS MED, PHARYNGITIS
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dimetapp, Septra
Current Illness: Mild URI/BOME
Preexisting Conditions: pt had LOM 9OCT90
Allergies:
Diagnostic Lab Data: WBC 7.1, VA = normal, urine callas=negative,blood culture
CDC Split Type:

Write-up: Pt vaccinated with DTP/OPV/MMR/PROHIBIT mild URI for 1 wk otitis one month ago otitis w/effusion at exam 7NOV developed Febrile seizure, temp 41, fluid in middle ear.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26626


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